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Methicillin-resistant Staphylococcus aureus bacteraemia associated with Lemierre's syndrome: case report and literature review

Published online by Cambridge University Press:  24 May 2013

V Kizhner ,
G Samara ,
R Panesar  and
Y P Krespi
V Kizhner*
Affiliation:
Department of Otolaryngology, St. Luke's-Roosevelt Hospital, New York, New York, USA
G Samara
Affiliation:
Department of Otolaryngology, Critical care, Stony Brook Hospital, New York, New York, USA
R Panesar
Affiliation:
Department of Pediatrics, Critical care, Stony Brook Hospital, New York, New York, USA
Y P Krespi
Affiliation:
Department of Otolaryngology, Lennox Hill Hospital, New York, New York, USA
*
Address for correspondence: Dr V Kizhner, Department of Otolaryngology, St. Luke's-Roosevelt Hospital, New York, NY, USA E-mail: [email protected]
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Abstract

Background:

Community-acquired methicillin-resistant Staphylococcus aureus is a growing health concern. Lemierre's syndrome is a septic jugular thrombophlebitis that primarily affects young adults. This paper aimed to identify a possible sub-group of Lemierre's syndrome cases associated with community-acquired methicillin-resistant Staphylococcus aureus.

Method:

This paper reports the case of a 16-year-old male who was admitted for increasing fever, tachycardia, tachypnoea and neck pain. The patient was diagnosed with methicillin-resistant Staphylococcus aureus bacteraemia associated with Lemierre's syndrome. A literature review was subsequently conducted.

Results:

Following intravenous antibiotic treatment and the sterilisation of blood cultures, the patient improved. The literature review indicated a rise in the past 2 years of Lemierre's syndrome associated with methicillin-resistant Staphylococcus aureus among patients less than 18 years of age.

Conclusion:

Community-acquired methicillin-resistant Staphylococcus aureus bacteraemia can lead to pulmonary sequelae. When it is associated with pharyngitis, nasopharyngitis or parapharyngeal lymphadenitis, the affected patient may be predisposed to Lemierre's syndrome. As bacterial carriage is predominantly nasal, pharyngitis may not be present. Methicillin-resistant Staphylococcus aureus should be included as an offending bacterium where there is suspicion of Lemierre's syndrome. It is unclear whether anticoagulation alters the course of the bacterium, and surgery is probably contraindicated.

Keywords

Lemierre SyndromeMRSAStaphylococcus AureusAnticoagulationChildPediatrics
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 7 , July 2013 , pp. 721 - 723
Copyright
Copyright © JLO (1984) Limited 2013 

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References

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